Childhood Apraxia of Speech
What is apraxia of speech?
Childhood apraxia of speech is a disorder that involves difficulty with the motor movements required for speech. It begins in childhood and often has an unknown etiology. When we create verbal speech, our brain sends a message to our mouth to tell the lips and tongue how/when to create each sound. Children with apraxia of speech require additional practice and supports to help send the motor message for movements from their brain. Children with childhood apraxia of speech may need speech therapy to help to produce vowels and consonants in sounds, syllables, words, and sentences in order to be understood by others and become more consistent. Apraxia of speech is often frustrating for the child and their family.
how is it diagnosed?
A speech-language pathologist (SLP) will conduct an evaluation to determine your child’s current strengths and aspects of their speech to improve upon. The evaluation will include informal and formal evaluations that can compare your child’s functioning to peers of a similar age and gender. The SLP will specifically look at your child’s range of motion, coordination, and physical characteristics of their speech structures, such as their lips, tongue, jaw, teeth, and hard and soft palate. Your child will also be asked to produce vowels and consonants in isolation, syllables, short words, and words with multiple syllables. The goal of the evaluation is to determine what sounds are difficult and the level of consistency, how your child transitions from shorter to longer words, and where stress is placed in their speech. Each child is different and requires an individualized approach to assessment and diagnosis. In general, apraxia of speech is not typically diagnosed until after 3 years of age.
What skills must a therapist have to treat childhood apraxia of speech?
In order to effectively treat childhood apraxia of speech, your child’s SLP needs to build a relationship with you and your child. This can be accomplished by learning information about your family’s expectations of speech therapy, your child’s likes/dislikes, and what toys/games your child enjoys in order to serve as a motivation in therapy. An SLP must be patient, enthusiastic, flexible, and knowledgeable on treatment methods for apraxia of speech.
What’s the difference between Childhood apraxia of speech and a language delay?
Apraxia of speech is a disorder that occurs in the muscle movements required for the sounds within words and sentences. For example, the child may say the word “cat” with different sounds, such as an /n/ or /t/ instead of a /k/. A language delay is when a child has difficulty understanding and/or using spoken language. A child with apraxia of speech understands what others are saying to them and knows what they want to communicate. They instead have difficulty producing the sounds within the word. Children with apraxia may be mistaken for having a language disorder if they are not communicating verbally at the level of same-aged peers.
WHAT DOES THE THERAPY LOOK LIKE?
There are a variety of treatment methods for apraxia of speech intervention. These include, but not limited to, PROMPT (otherwise known as PROMPTS for Restructuring Oral Muscular Phonetic Targets), Dynamic Temporal and Tactile Cueing (DTTC), Rapid Syllable Transition Training (ReST), and Integrated Phonological Awareness Training (IPA). Each apraxia of speech treatment emphasizes different aspects such as physical, sensory, or motor skills.
Treatment for apraxia of speech is individualized, but is often recommended for about 3x per week for the best results. Speech therapy will often focus on saying vowels, syllables, words, and strings of words correctly and consistently. The SLP will watch your child’s mouth as they say target syllables and words and provide proper prompting help them produce the correct sounds. The SLP may also provide activities for you and your child to do at home to ensure they are practicing and carrying over the skills learned in speech sessions.
If your child is becoming frustrated with communicating, the SLP may also recommend a form of alternative and augmentative communication (AAC) as a temporary way to help them express their thoughts and ideas to familiar and unfamiliar communication patterns. Depending on your child’s needs, this could include methods such as a low-technology device such as a picture cards, or a high-technology device such as a communication app. AAC is proven to not hinder speech development and can provide a way for your child to communicate as they learn and practice their verbal speech.
References:
Childhood apraxia of speech. American Speech-Language-Hearing Association. (n.d.). Retrieved from https://www.asha.org/public/speech/disorders/childhood-apraxia-of-speech/
Shipley, K. G., & McAfee, J. G. (2021). Childhood Apraxia of Speech. In Assessment in speech-language pathology: A resource manual (pp. 197–200). San Diego, CA: Plural Publishing.
Treatment methods. Child Apraxia Treatment. (n.d.). Retrieved April 17, 2022, from https://childapraxiatreatment.org/treatment-methods/